Mark Medoff wrote Children of a Lesser God specifically for the actress Phyllis Frelich. The play is important historically because it includes a lead role for a deaf performer in a drama designed for the hearing theater audience. Unlike some of Medoff's earlier plays, such as The Wager and When You Comin Back, Red Ryder?, Children of a Lesser God examines communication problems, psychological stress, and emotional abuse, but does so without the threat of physical violence or guns. The play earned Medoff a Tony award in 1980. In 1986, a film version of the play, written by Medoff, was released; the film starred William Hurt as James and Marlee Matlin, who earned an Academy Award for her performance as Sarah.
Sign language is integral to the play. Sarah signs but does not speak aloud until the climactic scene toward the end of the play. When conversing with Sarah, James will often echo her part of the conversation and sign and speak his own responses.